John Joseph Anderson Sr., RPH

Individual provider Active NPI Pharmacotherapy Pharmacist · Valdosta, GA

NPI 1992818801 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992818801
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacotherapy Pharmacist 1835P1200X
License
9482 (GA)
Practice address
1711 River St
Valdosta, GA 31601-5163
Phone
(229) 244-8868
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
9482GAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Pharmacy Services - Valdosta, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 9482 GA Yes

Addresses

Primary practice location

1711 River St
Valdosta, GA 31601-5163

Mailing address

2218 Brighton PL
Valdosta, GA 31602-2707
Phone (229) 242-0453

Other providers in Valdosta, GA

All providers in Valdosta, GA · Pharmacotherapy Pharmacist in Georgia

Sources for this page

Verify at the official NPI Registry.